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FAQ: when should I start my baby on solids?

Posted by Dr. Claire McCarthy  March 7, 2013 08:12 AM

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It's a milestone that parents get both excited and scared about: starting solids. Making that transition from breast milk or formula (or both) to stuff that requires spoons is something that many parents in my practice have lots of questions about.

It's not always easy to answer those questions, because the science behind the answers isn't always clear--and is still evolving. Plus, different doctors often have different opinions on the subject.

That said, here's what I'm telling my patients:
  • Babies should start solids between 4 and 6 months. 
  • They shouldn't start before they are ready to take the food off a spoon (don't mix it in the bottle, please!). If Baby pushes his tongue back or otherwise doesn't seem to know what to do with the spoon, put it away and try again in a week or two.
  • While exclusively breastfed babies really don't need solids before 6 months, recent research suggests that adding other foods improves iron levels (although breastfeeding alone doesn't leave babies without enough iron)
  • A study just out suggests that  starting cereals before 5.5 months (and fish before 9 months and egg before 11 months) can decrease the risk of asthma and allergies.
  • No matter what anybody tells you, there is no Best First Food. Cereal (but not rice cereal, because of arsenic) mixed with breast milk or formula, or a pureed fruit or vegetable, is usually what I recommend. If you buy it, get a single ingredient food (the ones marketed for starting out); if you make it, make sure there are no lumps and don't add any salt or sugar or anything else.
  • Give each new food a few days (at least three) before adding a new one. That makes it easier to pick up on any signs of an allergy or other problem (like diarrhea or constipation).
If you are breastfeeding, just because your baby has started solids doesn't mean you are okay to stop--the longer you keep at it, the better for your baby (but at least once they are on solids, you get a little bit of a break). 

My friend Dr. Wendy Sue Swanson wrote a great blog on this that is full of useful links--check it out.

Starting solids is the next step in teaching your child healthy eating habits for life. So make sure your child gets lots of fruits and vegetables--and use this time, before they are really watching what you eat, to make your own diet better. As your child grows, be a good role model!

Amy Nobile and I were on NECN recently talking about ways to get kids to eat healthy:

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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